Investigation of Molecular Typing and Drug Resistance of Shigella in Yunnan Province from 2016 to 2022
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摘要:
目的 对云南省2016—2022年食源性疾病主动监测分离的志贺氏菌进行血清、分子分型和药敏试验等分析,了解云南省志贺氏菌的病原学特性,为志贺氏菌感染的防控和治疗提供数据支持。 方法 2016年1月至2022年12月从患者粪便中分离志贺氏菌,采用玻片凝集法进行血清学分型,脉冲场凝胶电泳(PFGE)进行分子分型分析,微量肉汤稀释法进行药敏试验。 结果 共分离志贺氏菌89株,其中福氏志贺氏菌占52.81% ,宋内志贺氏菌占47.19% 。PFGE分析发现,2种志贺氏菌均分为A和B 2个聚类簇,B簇为优势簇。47株福氏志贺氏菌分为30种PFGE带型,有3组优势带型,42株宋内志贺氏菌分为22种PFGE带型,有4组优势带型,并识别两起疑似暴发事件。志贺氏菌对13种抗生素存在不同程度的耐药,78.65%的菌株为多重耐药菌株。 结论 云南省志贺氏菌PFGE优势带型明显,部分带型聚集分布。耐药形势严峻,多重耐药现象严重。福氏志贺氏菌和宋内志贺氏菌耐药表型存在差异。 Abstract:Objective To analyze the serum typing, PFGE molecular typing, and drug-resistance of Shigella strains isolated from the active surveillance for foodborne diseases in Yunnan province from 2016 to 2022, the aim is to understand the pathogen characteristics of Shigella in this period and provide the data support for the control and treatment of Shigella infection. Methods Shigella strains were isolated from the feces of patients between January 2016 and December 2022. Serological typing of the strains was performed using the slide agglutination. Pulsed field gel electrophoresis (PFGE) was employed to detect the molecular typing of the strains. Drug resistance test was achieved by the broth microdilution method. Results A total of 89 Shigella strains were isolated, of which Shigella flexneri accounted for 52.81% and Shigella sonnei 47.19%. Both Shigella flexneri and Shigella sonnei were divided into A and B clusters in PFGE analysis, with B as the predominant cluster. The PFGE bands of 47 Shigella flexneri strains were categorized as 30 types with 3 dominant classes, while 42 Shigella sonnei strains contained 22 types PFGE bands with 4 dominant classes. Two suspected outbreaks were distinguished. Shigella displayed varying degrees of drug resistance to 13 antibiotics, with a 78.65% of multiple resistant strains. Conclusion The dominant PFGE bands of Shigella in Yunnan province were clear, partial of which appeared the clustering distribution. The drug resistance of Shigella was severe and the phenomena of multiple drug resistance were very serious. Drug resistance prototypes between Shigella flexneri and Shigella sonnei were different. -
Key words:
- Shigella /
- Serum typing /
- Pulsed field gel electrophoresis /
- Drug-resistance
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表 1 云南省2016—2022年志贺氏菌血清型分布情况(n)
Table 1. Serum typing of Shigella in Yunnan province from 2016 to 2022 (n)
年份 福氏志贺氏菌血清型 福氏志贺菌合计 宋内志贺氏菌血清型 宋内志贺菌合计 总合计 1a 2a 2b 4a 4c 5b 6型 Y变种 Ⅰ相 Ⅱ相 2016年 0 8 0 1 0 0 0 0 9 2 7 9 18 2017年 0 10 0 0 0 0 0 0 10 0 0 0 10 2018年 1 4 0 0 1 1 2 1 10 1 7 8 18 2019年 0 6 1 0 0 0 1 0 8 11 12 23 31 2020年 2 7 0 0 0 0 0 0 9 1 1 2 11 2021年 0 1 0 0 0 0 0 0 1 0 0 0 1 2022年 0 0 0 0 0 0 0 0 0 0 0 0 0 合计 3 36 1 1 1 1 3 1 47 15 27 42 89 表 2 2016—2022年89株志贺氏菌对14种抗生素的药敏试验结果[n(%)]
Table 2. Tab. 2 Results of drug susceptibility test of 89 Shigella strains to 14 antibiotics from 2016 to 2022[n(%)]
抗生素 耐药率 χ2 P 47株福氏志贺菌 42株宋内志贺菌 合计 β内酰胺类 氨苄西林(AMP) 53.19(25/47) 73.81(31/42) 62.92(56/89) 4.041 0.044* 头孢唑啉(CFZ) 42.55(20/47) 69.05(29/42) 55.06(49/89) 6.292 0.012* 头孢噻肟(CTX) 21.28(10/47) 66.67(28/42) 42.70(38/89) 18.677 <0.001* 头孢他啶(CAZ) 8.51(4/47) 0.00(0/42) 4.49(4/89) − 0.073 阿奇霉素(AZM) 8.51(4/47) 69.05(29/42) 37.08(33/89) 34.840 <0.001* 亚胺培南(IMP) 0.00(0/47) 0.00(0/42) 0.00 (0/89) − − 氨苄西林/舒巴坦(AMS) 78.72(37/47) 59.52(25/42) 69.66(62/89) 3.869 0.049* 头霉素类 头孢西丁(CFX) 2.13(1/47) 0.00(0/42) 1.12(1/89) − 0.528 氨基糖苷类 庆大霉素(GEN) 8.51(4/47) 66.67(28/42) 35.96(32/89) 32.576 <0.001* 氟/喹诺酮类 环丙沙星(CIP) 38.30(18/47) 2.38(1/42) 21.35(19/89) 17.041 <0.001* 萘啶酸(NAL) 55.32(26/47) 78.57(33/42) 66.29(59/89) 5.367 0.021* 四环素类 四环素(TET) 61.70(29/47) 71.43(30/42) 66.29(59/89) 0.939 0.333 氯霉素类 氯霉素(CHL) 80.85(38/47) 2.38(1/42) 43.82(39/89) 55.477 <0.001* 磺胺类 甲氧苄啶/磺胺甲恶唑(SXT) 78.72(37/47) 76.19(32/42) 77.53(69/89) 0.082 0.775 *P < 0.05。 表 3 云南志贺氏菌对14种抗生素的多重耐药构成情况
Table 3. Multiple drug-resistance constitution of Shigella strains to 14 antibiotics
多重耐药 福氏志贺氏菌多重耐药情况 宋内志贺氏菌多重耐药情况 志贺氏菌多重耐药情况 耐药菌株数 构成比(%) 耐药菌株数 构成比(%) 耐药菌株数 构成比(%) 耐3类 5 10.64 2 4.76 7 7.87 耐4类 7 14.89 1 2.38 8 8.99 耐5类 1 2.13 0 0.00 1 1.12 耐6类 2 4.26 3 7.14 5 5.62 耐7类 9 19.15 1 2.38 10 11.24 耐8类 7 14.89 12 28.57 19 21.35 耐9类 4 8.51 14 33.33 18 20.22 耐10类 2 4.26 0 0.00 2 2.25 合计 37 78.72 33 78.57 70 78.65 表 4 89株志贺氏菌的多重耐药谱
Table 4. Multiple drug-resistance profiles of 89 Shigella strains
耐药
种类福氏志贺氏菌主要耐药谱 构成
比(%)宋内志贺氏菌主要耐药谱 构成
比(%)(菌株数) (菌株数) 7 CIP+SXT+CHL+NAL+TET+AMP+AMS(4) 8.51 CIP+NAL+CTX+TET+AMP+CFZ+SXT(1) 2.38 SXT+CHL+NAL+TET+AMP+AMS+CFZ(4) 8.51 SXT+CHL+GEN+TET+AMP+AMS+CFZ(1) 2.13 8 CIP+CHL+NAL+TET+CFX+AMP+AMS+CFZ(1) 2.13 NAL+GEN+TET+CTX+AZM+AMP+CFZ+SXT(8) 19.05 CIP+SXT+CHL+NAL+TET+CTX+AMP+AMS(1) 2.13 NAL+GEN+TET+CTX+AMP+AMS+CFZ+SXT(1) 2.38 SXT+CHL+NAL+TET+CTX+AMP+AMS+CFZ(3) 6.38 NAL+GEN+CTX+AZM+AMP+AMS+CFZ+SXT(3) 7.14 CIP+SXT+CHL+NAL+TET+AMP+AMS+CFZ(1) 2.13 SXT+CHL+NAL+TET+GEN+AZM+AMP+AMS(1) 2.13 9 SXT+CHL+NAL+TET+CTX+AMP+AMS+CAZ+CFZ(1) 2.13 CHL+NAL+GEN+TET+CTX+AMP+AMS+CFZ+SXT(1) 2.38 CIP+SXT+CHL+NAL+TET+CTX+AMP+AMS+CFZ(1) 2.13 NAL+GEN+TET+CTX+AZM+AMP+AMS+CFZ+SXT(13) 30.95 CIP+SXT+CHL+NAL+TET+AZM+AMP+AMS+CFZ(1) 2.13 SXT+NAL+GEN+TET+CTX+AZM+AMP+AMS+CFZ(1) 2.13 10 CIP+SXT+CHL+NAL+TET+CTX+AMP+AMS+CAZ+CFZ(1) 2.13 无 0.00 -
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